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Florida HMO Program

Florida HMO Program

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Published by Michele Lentz

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Published by: Michele Lentz on May 07, 2012
Copyright:Attribution Non-commercial

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05/07/2012

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FloridaNon-ReformHMOProgram
September2010~August2011DraftCapitationRates
PresentedbyJohnD.Meerschaert,FSA,MAAAPrincipalandConsultingActuarySteveG.Hanson,ASA,MAAAAssociateActuary
August5,2010
a
Milliman
 
Agenda
..GeneralMethodologyforNon-Reform..DraftNon-ReformCapitationRates..Fee-For-ServiceMethod
-IncludestheMentalHealthAdd-on
..FinancialDataMethod..PharmacyEncounterDataMethod..NextSteps..Questions
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August5,2010
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GeneralRateMethodology
AHCAhashistoricallysetnon-reformHMOratesusingFFSdataastheexperiencebaseIngeneral,AHCAwantstomoveawayfromrelyingonFFSdataandtowardsaratesettingmethodologythatreliesmoreonHMOdata
-Thesedraftratesarethefirststepinthatprocess
AHCArecognizestheadvantageofrelyingmoreonHMOdatausingamulti-yearphase-inapproach
-Promotesmoreratestability-ProvidesmoretimetovalidateHMOdata
3
August5,2010
a
Milliman

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